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Reitz SC, Gerhard E, Breuer S, Bohmann FO, Pfeilschifter W, Berkefeld J. Outcome after Thrombectomy of Acute M1 and Carotid-T Occlusions with Involvement of the Corticospinal Tract in Postinterventional Imaging. J Clin Med 2022; 11:jcm11102823. [PMID: 35628948 PMCID: PMC9145944 DOI: 10.3390/jcm11102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Until now, thrombectomy studies have provided little reliable information about the correlation between the infarct topography and clinical outcome of acute stroke patients with embolic large-vessel occlusions. Therefore, we aimed to analyze whether infarcts of the corticospinal tracts in the central white matter (CWM) or the internal capsule on postinterventional imaging controls are associated with poor clinical outcome after thrombectomy. MATERIALS AND METHODS We retrospectively analyzed imaging data from 70 patients who underwent endovascular thrombectomy for emergent middle cerebral artery or carotid-T occlusions. Inclusion criteria were postinterventional infarct demarcation in the regions of the internal capsule, caudate, lentiform nucleus, and CWM. Primary outcome was the mRS after 90 days and secondary endpoints were subgroup analyses regarding additional cortical infarction. CONCLUSIONS In this exploratory study, we found no indication that infarcts in the course of the corticospinal tracts predict poor clinical outcome after successful thrombectomy in patients with embolic carotid-T or M1 occlusions. In our analysis, a significant number of patients showed a favorable 90 day outcome. Additional cortical infarcts may have a greater impact on the risk of an unfavorable outcome. RESULTS Good clinical outcome after 90 days (mRS 0-2) was shown in 36 out of 70 patients (51.4%), with excellent clinical outcome (mRS 0-1) in 23 patients (32.9%). Here, 58.6% patients lived at home without nursing service after 90 days. Patients with minimal additional cortical infarction in postinterventional imaging had a 75.6% better chance of excellent outcome.
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Affiliation(s)
- Sarah Christina Reitz
- Department of Neurology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt am Main, Germany; (F.O.B.); (W.P.)
- Correspondence:
| | - Ellen Gerhard
- Institute of Neuroradiology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt am Main, Germany; (E.G.); (S.B.); (J.B.)
| | - Stella Breuer
- Institute of Neuroradiology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt am Main, Germany; (E.G.); (S.B.); (J.B.)
| | - Ferdinand Oliver Bohmann
- Department of Neurology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt am Main, Germany; (F.O.B.); (W.P.)
| | - Waltraud Pfeilschifter
- Department of Neurology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt am Main, Germany; (F.O.B.); (W.P.)
- Klinik für Neurologie und Klinische Neurophysiologie, Klinikum Lüneburg, 21339 Lüneburg, Germany
| | - Joachim Berkefeld
- Institute of Neuroradiology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt am Main, Germany; (E.G.); (S.B.); (J.B.)
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2
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Simão CR, DE Holanda LJ, Urbini LF, Lacerda MO, Fernandes K, DA Silva PM, Morya E, Lindquist AR. Surface electromyography to identify top-down modulation in complete chronic spinal cord injury. Eur J Phys Rehabil Med 2022; 58:144-149. [PMID: 34468111 PMCID: PMC9980542 DOI: 10.23736/s1973-9087.21.06878-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Complete spinal cord injury (SCI) is characterized by permanent loss of nerve impulse propagation through the injury level leading to complete loss of voluntary muscle contraction. However, clinically undetectable top-down modulation of lower limbs might be present and can be evidenced using surface electromyography (sEMG). CASE REPORT A subject with complete chronic SCI and no spasticity presents voluntary modulation of sEMG signal during a task-specific activity associated with sensory input. CLINICAL REHABILITATION IMPACT We present for the first time the spectral characterization of sEMG signal in response to orthostatic training associated with voluntary movement attempts in complete SCI. Behavior of sEMG signal varied according to kinematic properties of movement, reinforcing the voluntary influence of efferent pathways on motor output. Our findings will contribute to elaborate evaluation protocols to investigate the preservation of corticospinal activities, and to evolve more accessible strategies in a clinical setting.
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Affiliation(s)
- Camila R Simão
- Graduate Program in Physical Therapy, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil.,Graduate Program in Neuroengineering, Edmond and Lily Safra International Neuroscience Institute, Macaíba, Brazil.,Santos Dumont Institute, Macaíba, Brazil.,Anita Garibaldi Center for Education and Research in Health, Santos Dumont Institute, Macaíba, Brazil
| | - Ledycnarf J DE Holanda
- Graduate Program in Physical Therapy, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil.,Graduate Program in Neuroengineering, Edmond and Lily Safra International Neuroscience Institute, Macaíba, Brazil.,Santos Dumont Institute, Macaíba, Brazil
| | - Lilian F Urbini
- Graduate Program in Neuroengineering, Edmond and Lily Safra International Neuroscience Institute, Macaíba, Brazil.,Santos Dumont Institute, Macaíba, Brazil
| | - Matheus O Lacerda
- Graduate Program in Physical Therapy, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Karina Fernandes
- Graduate Program in Physical Therapy, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Patrícia M DA Silva
- Graduate Program in Physical Therapy, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil.,Graduate Program in Neuroengineering, Edmond and Lily Safra International Neuroscience Institute, Macaíba, Brazil.,Santos Dumont Institute, Macaíba, Brazil
| | - Edgard Morya
- Graduate Program in Neuroengineering, Edmond and Lily Safra International Neuroscience Institute, Macaíba, Brazil.,Santos Dumont Institute, Macaíba, Brazil.,Anita Garibaldi Center for Education and Research in Health, Santos Dumont Institute, Macaíba, Brazil
| | - Ana R Lindquist
- Graduate Program in Physical Therapy, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil -
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3
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Cao Y, Shi Y, Xiao Z, Chen X, Chen B, Yang B, Shu M, Yin Y, Wu S, Yin W, Fu X, Tan J, Zhou Q, Wu Z, Jiang X, Dai J. Contralateral Axon Sprouting but Not Ipsilateral Regeneration Is Responsible for Spontaneous Locomotor Recovery Post Spinal Cord Hemisection. Front Cell Neurosci 2021; 15:730348. [PMID: 34512270 PMCID: PMC8426601 DOI: 10.3389/fncel.2021.730348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury (SCI) usually results in permanent functional impairment and is considered a worldwide medical problem. However, both motor and sensory functions can spontaneously recover to varying extents in humans and animals with incomplete SCI. This study observed a significant spontaneous hindlimb locomotor recovery in Sprague-Dawley rats at four weeks after post-right-side spinal cord hemisection at thoracic 8 (T8). To verify whether the above spontaneous recovery derives from the ipsilateral axonal or neuronal regeneration to reconnect the lesion site, we resected either the scar tissue or right side T7 spinal cord at five weeks post-T8 hemisected injury. The results showed that the spontaneously achieved right hindlimb locomotor function had little change after resection. Furthermore, when T7 left hemisection was performed five weeks after the initial injury, the spontaneously achieved right hindlimb locomotor function was dramatically abolished. A similar result could also be observed when T7 transection was performed after the initial hemisection. The results indicated that it might be the contralateral axonal remolding rather than the ipsilateral axonal or neuronal regeneration beyond the lesion site responsible for the spontaneous hindlimb locomotor recovery. The immunostaining analyses and corticospinal tracts (CSTs) tracing results confirmed this hypothesis. We detected no substantial neuronal and CST regeneration throughout the lesion site; however, significantly more CST fibers were observed to sprout from the contralateral side at the lumbar 4 (L4) spinal cord in the hemisection model rats than in intact ones. In conclusion, this study verified that contralateral CST sprouting, but not ipsilateral CST or neuronal regeneration, is primarily responsible for the spontaneous locomotor recovery in hemisection SCI rats.
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Affiliation(s)
- Yudong Cao
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Ya Shi
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Zhifeng Xiao
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Xi Chen
- Shigatse Branch, Xinqiao Hospital, Army Medical University (Third Military Medical University), Shigatse, China
| | - Bing Chen
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Bin Yang
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Muya Shu
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Yanyun Yin
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Shuyu Wu
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Wen Yin
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Xianyong Fu
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Jun Tan
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Quanwei Zhou
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Zhaoping Wu
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Xingjun Jiang
- Department of Neurosurgery, Xiangya Hospital, Central South University (CSU), Changsha, China
| | - Jianwu Dai
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
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4
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Osaki Y, Sako W, Harada M, Izumi Y. Magnetic resonance tractography exhibiting retrograde degeneration of the corticospinal tract in a patient with a unilateral spinal cord tumor. Brain Behav 2021; 11:e02020. [PMID: 33638938 PMCID: PMC8035459 DOI: 10.1002/brb3.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Transection-induced axonal retrograde degeneration, in contrast to Wallerian degeneration, has not been widely recognized in clinical practice. AIMS OF THE STUDY To assess a potential of corticospinal tractography for detecting axonal retrograde degeneration. METHODS We assessed the corticospinal tractography of a 74-year-old woman with monoplegia of the lower limb due to a unilateral thoracic spinal cord tumor. RESULTS The tractography revealed integrity reduction of the corticospinal tract in the cerebra contralateral to the spinal cord tumor. CONCLUSIONS The present report supports that magnetic resonance tractography has the potential for detecting this under-recognized phenomenon.
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Affiliation(s)
- Yusuke Osaki
- Department of Neurology, Tokushima University Hospital, Tokushima, Japan
| | - Wataru Sako
- Department of Neurology, Tokushima University Hospital, Tokushima, Japan
| | - Masafumi Harada
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Yuishin Izumi
- Department of Neurology, Tokushima University Hospital, Tokushima, Japan
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5
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Yamaura G, Ogasawara A, Ito T, Ohsugi S, Kanatsuka Y, Hayashi R, Iwashita H, Hayashi H, Koyano S, Yamaguchi S, Tanaka F. Pathologically Proven Gadolinium-enhanced MRI Lesions in the Bilateral Corticospinal Tracts in Lymphomatosis Cerebri. Intern Med 2020; 59:2931-2934. [PMID: 32713909 PMCID: PMC7725641 DOI: 10.2169/internalmedicine.4382-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
A 78-year-old woman in complete remission of mass-forming primary central nervous system lymphoma (PCNSL) showed diffuse leukoencephalopathy as well as corticospinal tract lesions with intense gadolinium enhancement on magnetic resonance imaging (MRI). She died 3 months later. In line with the MRI findings, pathological examination revealed dense infiltration of atypical lymphoid cells, consistent with a diagnosis of lymphomatosis cerebri (LC)-type PCNSL. This is the first report of LC in which the corticospinal tracts demonstrated robust contrast enhancement directly corresponding to the neuropathological findings, and it is also a rare instance in which LC presented as a recurrence of typical PCNSL.
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Affiliation(s)
- Genpei Yamaura
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan
| | - Akihiro Ogasawara
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan
| | - Takeshi Ito
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan
| | - Shizuka Ohsugi
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan
| | - Yoichi Kanatsuka
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan
| | - Ryuichiro Hayashi
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan
| | | | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen's Hospital, Japan
| | - Shigeru Koyano
- Department of Neurology, Yokohama Minami Kyousai Hospital, Japan
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
| | - Shigeki Yamaguchi
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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6
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Papadelis C, Kaye H, Shore B, Snyder B, Grant PE, Rotenberg A. Maturation of Corticospinal Tracts in Children With Hemiplegic Cerebral Palsy Assessed by Diffusion Tensor Imaging and Transcranial Magnetic Stimulation. Front Hum Neurosci 2019; 13:254. [PMID: 31396066 PMCID: PMC6668599 DOI: 10.3389/fnhum.2019.00254] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/08/2019] [Indexed: 11/16/2022] Open
Abstract
Aim: To assess changes in the developmental trajectory of corticospinal tracts (CST) maturation in children with hemiplegic cerebral palsy (HCP). Methods: Neuroimaging data were obtained from 36 children with HCP for both the more affected (MA) and less affected (LA) hemispheres, and, for purposes of direct comparison, between groups, 15 typically developing (TD) children. With diffusion tensor imaging (DTI), we estimated the mean fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) of the corticospinal tract, parameters indicative of factors including myelination and axon density. Transcranial magnetic stimulation (TMS) was performed as a neurophysiologic measure of corticospinal tract integrity and organization. Resting motor threshold (rMT) was obtained per hemisphere, per patient. Results: We observed a significant AD and MD developmental trajectory, both of which were inversely related to age (decrease in AD and diffusivity corresponding to increased age) in both hemispheres of TD children (p < 0.001). This maturation process was absent in both MA and LA hemispheres of children with HCP. Additionally, the TMS-derived previously established rMT developmental trajectory was preserved in the LA hemisphere of children with HCP (n = 26; p < 0.0001) but this trajectory was absent in the MA hemisphere. Conclusions: Corticospinal tract maturation arrests in both hemispheres of children with HCP, possibly reflecting perinatal disruption of corticospinal tract myelination and axonal integrity.
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Affiliation(s)
- Christos Papadelis
- Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Harper Kaye
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, United States
| | - Benjamin Shore
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Brian Snyder
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Patricia Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexander Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, United States.,Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, United States
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7
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Ishaque A, Mah D, Seres P, Luk C, Johnston W, Chenji S, Beaulieu C, Yang YH, Kalra S. Corticospinal tract degeneration in ALS unmasked in T1-weighted images using texture analysis. Hum Brain Mapp 2018; 40:1174-1183. [PMID: 30367724 DOI: 10.1002/hbm.24437] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/20/2018] [Accepted: 10/12/2018] [Indexed: 11/06/2022] Open
Abstract
The purpose of this study was to investigate whether textures computed from T1-weighted (T1W) images of the corticospinal tract (CST) in amyotrophic lateral sclerosis (ALS) are associated with degenerative changes evaluated by diffusion tensor imaging (DTI). Nineteen patients with ALS and 14 controls were prospectively recruited and underwent T1W and diffusion-weighted magnetic resonance imaging. Three-dimensional texture maps were computed from T1W images and correlated with the DTI metrics within the CST. Significantly correlated textures were selected and compared within the CST for group differences between patients and controls using voxel-wise analysis. Textures were correlated with the patients' clinical upper motor neuron (UMN) signs and their diagnostic accuracy was evaluated. Voxel-wise analysis of textures and their diagnostic performance were then assessed in an independent cohort with 26 patients and 13 controls. Results showed that textures autocorrelation, energy, and inverse difference normalized significantly correlated with DTI metrics (p < .05) and these textures were selected for further analyses. The textures demonstrated significant voxel-wise differences between patients and controls in the centrum semiovale and the posterior limb of the internal capsule bilaterally (p < .05). Autocorrelation and energy significantly correlated with UMN burden in patients (p < .05) and classified patients and controls with 97% accuracy (100% sensitivity, 92.9% specificity). In the independent cohort, the selected textures demonstrated similar regional differences between patients and controls and classified participants with 94.9% accuracy. These results provide evidence that T1-based textures are associated with degenerative changes in the CST.
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Affiliation(s)
- Abdullah Ishaque
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Dennell Mah
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Peter Seres
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Collin Luk
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Wendy Johnston
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Sneha Chenji
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Yee-Hong Yang
- Department of Computing Sciences, University of Alberta, Edmonton, Canada
| | - Sanjay Kalra
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada.,Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada.,Department of Biomedical Engineering, University of Alberta, Edmonton, Canada.,Department of Computing Sciences, University of Alberta, Edmonton, Canada
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8
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Li X, Wang Y, Wang Z, Wang P, Shao C, Ye J. Recovery of injured corticospinal tracts after late recanalisation of basilar artery occlusion. Stroke Vasc Neurol 2018; 3:253-255. [PMID: 30637132 PMCID: PMC6312069 DOI: 10.1136/svn-2018-000140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/26/2018] [Accepted: 08/06/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Xiaodi Li
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Yuzhou Wang
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Zhanhang Wang
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Peiming Wang
- Department of Neurointervention, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Chuanxing Shao
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Jinlong Ye
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
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9
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Merchant SHI. Evidence already exists for motor system reorganization in CRPS. Can J Pain 2018; 2:27-29. [PMID: 35005362 PMCID: PMC8730546 DOI: 10.1080/24740527.2017.1422976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 12/28/2017] [Accepted: 12/28/2017] [Indexed: 11/14/2022]
Abstract
Complex regional pain syndrome (CRPS) is a disabling condition that is usually preceded by trauma or surgical procedure. Involvement of the motor system is a well-known phenomenon in CRPS, though the pathophysiologic mechanisms of motor system affliction in CRPS are poorly understood. Graded motor imagery (GMI) has been proposed to be one of the therapeutic interventions to help improve pain and other disabling symptoms associated with CRPS, though the benefits noted are modest and inconsistent. The neurophysiological mechanisms implicated in motor imagery are intended to target the aberrant prefrontal and sensorimotor integration areas, which may potentially help restore the aberrant cortical plasticity in CRPS. Detailed well-controlled experiments using insights from the existing body of literature on motor system reorganization in CRPS are required to better understand this complicated disorder. Attempts to gain pathophysiologic insights about complicated disorders like CRPS based on case reports with poorly performed and uncontrolled interventions are misguided.
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Affiliation(s)
- Shabbir Hussain I. Merchant
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
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10
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Kuczynski AM, Dukelow SP, Hodge JA, Carlson HL, Lebel C, Semrau JA, Kirton A. Corticospinal tract diffusion properties and robotic visually guided reaching in children with hemiparetic cerebral palsy. Hum Brain Mapp 2017; 39:1130-1144. [PMID: 29193460 DOI: 10.1002/hbm.23904] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/01/2017] [Accepted: 11/22/2017] [Indexed: 12/20/2022] Open
Abstract
Perinatal stroke is the leading cause of hemiparetic cerebral palsy (CP), resulting in life-long disability. In this study, we examined the relationship between robotic upper extremity motor impairment and corticospinal tract (CST) diffusion properties. Thirty-three children with unilateral perinatal ischemic stroke (17 arterial, 16 venous) and hemiparesis were recruited from a population-based research cohort. Bilateral CSTs were defined using diffusion tensor imaging (DTI) and four diffusion metrics were quantified: fractional anisotropy (FA), mean (MD), radial (RD), and axial (AD) diffusivities. Participants completed a visually guided reaching task using the KINARM robot to define 10 movement parameters including movement time and maximum speed. Twenty-six typically developing children underwent the same evaluations. Partial correlations assessed the relationship between robotic reaching and CST diffusion parameters. All diffusion properties of the lesioned CST differed from controls in the arterial group, whereas only FA was reduced in the venous group. Non-lesioned CST diffusion measures were similar between stroke groups and controls. Both stroke groups demonstrated impaired reaching performance. Multiple reaching parameters of the affected limb correlated with lesioned CST diffusion properties. Lower FA and higher MD were associated with greater movement time. Few correlations were observed between non-lesioned CST diffusion and unaffected limb function though FA was associated with reaction time (R = -0.39, p < .01). Diffusion properties of the lesioned CST are altered after perinatal stroke, the degree of which correlates with specific elements of visually guided reaching performance, suggesting specific relevance of CST structural connectivity to clinical motor function in hemiparetic children.
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Affiliation(s)
- Andrea M Kuczynski
- University of Calgary, Calgary, Alberta, Canada.,Section of Neurology, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Sean P Dukelow
- University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Jacquie A Hodge
- Section of Neurology, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Helen L Carlson
- Section of Neurology, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Catherine Lebel
- University of Calgary, Calgary, Alberta, Canada.,Department of Radiology, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Jennifer A Semrau
- University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Adam Kirton
- University of Calgary, Calgary, Alberta, Canada.,Section of Neurology, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, Hotchkiss Brain Institute, Calgary, Alberta, Canada
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11
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Peterson CL, Rogers LM, Bednar MS, Bryden AM, Keith MW, Perreault EJ, Murray WM. Posture-Dependent Corticomotor Excitability Differs Between the Transferred Biceps in Individuals With Tetraplegia and the Biceps of Nonimpaired Individuals. Neurorehabil Neural Repair 2016; 31:354-363. [PMID: 27932695 DOI: 10.1177/1545968316680488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Following biceps transfer to enable elbow extension in individuals with tetraplegia, motor re-education may be facilitated by greater corticomotor excitability. Arm posture modulates corticomotor excitability of the nonimpaired biceps. If arm posture also modulates excitability of the transferred biceps, posture may aid in motor re-education. OBJECTIVE Our objective was to determine whether multi-joint arm posture affects corticomotor excitability of the transferred biceps similar to the nonimpaired biceps. We also aimed to determine whether corticomotor excitability of the transferred biceps is related to elbow extension strength and muscle length. METHODS Corticomotor excitability was assessed in 7 arms of individuals with tetraplegia and biceps transfer using transcranial magnetic stimulation and compared to biceps excitability of nonimpaired individuals. Single-pulse transcranial magnetic stimulation was delivered to the motor cortex with the arm in functional postures at rest. Motor-evoked potential amplitude was recorded via surface electromyography. Elbow moment was recorded during maximum isometric extension trials, and muscle length was estimated using a biomechanical model. RESULTS Arm posture modulated corticomotor excitability of the transferred biceps differently than the nonimpaired biceps. Elbow extension strength was positively related and muscle length was unrelated, respectively, to motor-evoked potential amplitude across the arms with biceps transfer. CONCLUSIONS Corticomotor excitability of the transferred biceps is modulated by arm posture and may contribute to strength outcomes after tendon transfer. Future work should determine whether modulating corticomotor excitability via posture promotes motor re-education during the rehabilitative period following surgery.
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Affiliation(s)
- Carrie L Peterson
- 1 Edward Hines, Jr. VA Hospital, Hines, IL, USA.,2 Rehabilitation Institute of Chicago, Chicago, IL, USA.,3 Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lynn M Rogers
- 2 Rehabilitation Institute of Chicago, Chicago, IL, USA.,3 Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael S Bednar
- 1 Edward Hines, Jr. VA Hospital, Hines, IL, USA.,4 Loyola University-Chicago, Maywood, IL, USA
| | - Anne M Bryden
- 5 The Cleveland FES Center at MetroHealth, Cleveland, OH, USA.,6 Case Western Reserve University, Cleveland, OH, USA
| | - Michael W Keith
- 5 The Cleveland FES Center at MetroHealth, Cleveland, OH, USA.,6 Case Western Reserve University, Cleveland, OH, USA
| | - Eric J Perreault
- 2 Rehabilitation Institute of Chicago, Chicago, IL, USA.,3 Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,7 Northwestern University, Evanston, IL, USA
| | - Wendy M Murray
- 1 Edward Hines, Jr. VA Hospital, Hines, IL, USA.,2 Rehabilitation Institute of Chicago, Chicago, IL, USA.,3 Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,7 Northwestern University, Evanston, IL, USA
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Abstract
To define the relationship between the complete destruction of 1 lateral corticospinal tract (CST), as demonstrated by diffusion tensor imaging (DTI) tractography, and ambulatory function 6 months following stroke.Twenty-six adults (17 male, 9 female) with poststroke hemiplegia who were transferred to the physical medicine and rehabilitation department. Participants underwent DTI tractography, which showed that 1 lateral CST had been clearly destroyed.Functional ambulation classification (FAC) scores at admission, discharge, and 6 months after discharge were used to evaluate the patients' ability to walk. The National Institutes of Health Stroke Scale (NIHSS) and the Korean version of the modified Barthel index (K-MBI) at admission, discharge, and 6 months after discharge were used to evaluate the degree of functional recovery.Of the 26 patients, 18 were nonambulatory (FAC level 1-3), and 8 were able to walk without support (FAC level 4-6). The type of stroke (infarction or hemorrhage), site of the lesion, spasticity of lower extremities, cranioplasty, and the time taken from onset to MRI were not statistically significantly correlated with the ability to walk. However, statistically significant correlations were found in relation to age, K-MBI scores, and initial NIHSS scores.Despite the complete damage to the lesion site and the preservation of 1 unilateral CST, as shown by DTI, good outcomes can be predicted on the basis of younger age, low NIHSS scores, and high MBI scores at onset.
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Affiliation(s)
| | | | - Hyoung Seop Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea
- Correspondence: Hyoung Seop Kim, National Health Insurance Service Ilsan Hospital, Ilsan-ro 100, ilsan-donggu, Goyang, Korea, 10444 (e-mail: )
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Abstract
An 80 year old lady with a history of metastatic sigmoid carcinoma presented with expressive dysphasia and unsteady gait 4 days after commencement of adjuvant capecitabine chemotherapy. MRI demonstrated restricted diffusion and T2/FLAIR hyperintensity involving the course of the bilateral corticospinal tracts, the corpus callosum and the middle cerebellar peduncles. Discontinuation of chemotherapy lead to symptom resolution in 2 days; repeat MRI at 2 months demonstrated reversal of the diffusion changes and improvement of the previous T2W/FLAIR hyperintensity. This report describes the first case of capecitabine induced leukoencephalopathy causing restricted diffusion along the corticospinal tracts, which should be differentiated from other entities that involve the corticospinal tracts (i.e. amyotrophic lateral sclerosis (ALS), primary lateral sclerosis (PLS), hypoglycemic coma, etc.).
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Affiliation(s)
- Mark Bang-Wei Tan
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
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Xie R, Fang M, Zhou L, Fan S, Liu J, Quan H, Luo M, Qiu D. Diffusion tensor imaging detects Wallerian degeneration of the corticospinal tract early after cerebral infarction. Neural Regen Res 2015; 7:900-5. [PMID: 25722673 PMCID: PMC4341284 DOI: 10.3969/j.issn.1673-5374.2012.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 02/20/2012] [Indexed: 11/18/2022] Open
Abstract
To investigate the feasibility and time window of early detection of Wallerian degeneration in the corticospinal tract after middle cerebral artery infarction, 23 patients were assessed using magnetic resonance diffusion tensor imaging at 3.0T within 14 days after the infarction. The fractional anisotropy values of the affected corticospinal tract began to decrease at 3 days after onset and decreased in all cases at 7 days. The diffusion coefficient remained unchanged. Experimental findings indicate that diffusion tensor imaging can detect the changes associated with Wallerian degeneration of the corticospinal tract as early as 3 days after cerebral infarction.
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Affiliation(s)
- Ruiman Xie
- Department of Neurology and Gerontology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Min Fang
- Department of Neurology and Gerontology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Linjiang Zhou
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shanghua Fan
- Department of Neurology and Gerontology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jianying Liu
- Department of Neurology and Gerontology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Hongbo Quan
- Department of Neurology and Gerontology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Man Luo
- Department of Neurology and Gerontology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Dongying Qiu
- Department of Neurology and Gerontology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Forostyak S, Jendelova P, Sykova E. The role of mesenchymal stromal cells in spinal cord injury, regenerative medicine and possible clinical applications. Biochimie 2013; 95:2257-70. [DOI: 10.1016/j.biochi.2013.08.004] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 08/05/2013] [Indexed: 12/13/2022]
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Li J, Chen X, Zhang J, Zheng G, Lv X, Li F, Hu S, Zhang T, Xu B. Intraoperative diffusion tensor imaging predicts the recovery of motor dysfunction after insular lesions. Neural Regen Res 2013; 8:1400-9. [PMID: 25206435 PMCID: PMC4107766 DOI: 10.3969/j.issn.1673-5374.2013.15.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 04/02/2013] [Indexed: 12/02/2022] Open
Abstract
Insular lesions remain surgically challenging because of the need to balance aggressive resection and functional protection. Motor function deficits due to corticospinal tract injury are a common complication of surgery for lesions adjacent to the internal capsule and it is therefore essential to evaluate the corticospinal tract adjacent to the lesion. We used diffusion tensor imaging to evaluate the corticospinal tract in 89 patients with insular lobe lesions who underwent surgery in Chinese PLA General Hospital from February 2009 to May 2011. Postoperative motor function evaluation revealed that 57 patients had no changes in motor function, and 32 patients suffered motor dysfunction or aggravated motor dysfunction. Of the affected patients, 20 recovered motor function during the 6–12-month follow-up, and an additional 12 patients did not recover over more than 12 months of follow-up. Following reconstruction of the corticospinal tract, fractional anisotropy comparison demonstrated that preoperative, intraoperative and follow-up normalized fractional anisotropy in the stable group was higher than in the transient deficits group or the long-term deficits group. Compared with the transient deficits group, intraoperative normalized fractional anisotropy significantly decreased in the long-term deficits group. We conclude that intraoperative fractional anisotropy values of the corticospinal tracts can be used as a prognostic indicator of motor function outcome.
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Affiliation(s)
- Jinjiang Li
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiaolei Chen
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Jiashu Zhang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Gang Zheng
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Xueming Lv
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Fangye Li
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Shen Hu
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Ting Zhang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Bainan Xu
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
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Zanin E, Ranjeva J, Confort‐Gouny S, Guye M, Denis D, Cozzone PJ, Girard N. White matter maturation of normal human fetal brain. An in vivo diffusion tensor tractography study. Brain Behav 2011; 1:95-108. [PMID: 22399089 PMCID: PMC3236541 DOI: 10.1002/brb3.17] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 07/08/2011] [Accepted: 08/01/2011] [Indexed: 01/02/2023] Open
Abstract
We demonstrate for the first time the ability to determine in vivo and in utero the transitions between the main stages of white matter (WM) maturation in normal human fetuses using magnetic resonance diffusion tensor imaging (DTI) tractography. Biophysical characteristics of water motion are used as an indirect probe to evaluate progression of the tissue matrix organization in cortico-spinal tracts (CSTs), optic radiations (OR), and corpus callosum (CC) in 17 normal human fetuses explored between 23 and 38 weeks of gestation (GW) and selected strictly on minimal motion artifacts. Nonlinear polynomial (third order) curve fittings of normalized longitudinal and radial water diffusivities (Z-scores) as a function of age identify three different phases of maturation with specific dynamics for each WM bundle type. These phases may correspond to distinct cellular events such as axonal organization, myelination gliosis, and myelination, previously reported by other groups on post-mortem fetuses using immunostaining methods. According to the DTI parameter dynamics, we suggest that myelination (phase 3) appears early in the CSTs, followed by the OR and by the CC, respectively. DTI tractography provides access to a better understanding of fetal WM maturation.
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Affiliation(s)
- Emilie Zanin
- Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612, Faculté de Médecine de Marseille, Université de la Méditerranée, Aix‐Marseille II, France
- Service d’Ophtalmologie, Centre hospitalo‐universitaire Nord, Assistance Publique des Hôpitaux de Marseille, France
| | - Jean‐Philippe Ranjeva
- Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612, Faculté de Médecine de Marseille, Université de la Méditerranée, Aix‐Marseille II, France
| | - Sylviane Confort‐Gouny
- Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612, Faculté de Médecine de Marseille, Université de la Méditerranée, Aix‐Marseille II, France
| | - Maxime Guye
- Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612, Faculté de Médecine de Marseille, Université de la Méditerranée, Aix‐Marseille II, France
| | - Daniele Denis
- Service d’Ophtalmologie, Centre hospitalo‐universitaire Nord, Assistance Publique des Hôpitaux de Marseille, France
| | - Patrick J. Cozzone
- Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612, Faculté de Médecine de Marseille, Université de la Méditerranée, Aix‐Marseille II, France
| | - Nadine Girard
- Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612, Faculté de Médecine de Marseille, Université de la Méditerranée, Aix‐Marseille II, France
- Service de Neuroradiologie Diagnostique et Interventionelle, Centre hospitalo‐universitaire de la Timone, Assistance Publique des Hôpitaux de Marseille, France
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18
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Wassermann EM, Tormos JM, Pascual-Leone A. Finger movements induced by transcranial magnetic stimulation change with hand posture, but not with coil position. Hum Brain Mapp 1998; 6:390-3. [PMID: 9788078 PMCID: PMC6873379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
We attempted to map the representations of movements in 2 normal subjects by delivering five transcranial magnetic stimuli (TMS) with a focal coil to each of a grid of positions over the primary motor area (M1). Isometric forces were recorded from the contralateral index finger. Maps were made with the hand in a semiflexed "neutral" position, and with the thumb and index finger opposed in a "pincer" grip. The electromyogram (EMG) was monitored to ensure relaxation. The wrist was immobilized. In the neutral position, TMS at almost all positions produced abduction. Flexion was produced in the pincer position. Thus, while sensitive to changes in posture, TMS mapping may not be sensitive to the topographical organization of the M1 by movements as detected with direct cortical stimulation.
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Affiliation(s)
- E M Wassermann
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland 20892, USA.
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